In some populations of women, bacterial vaginosis (nonspecific vaginitis) is more prevalent than yeast vaginitis or Trichomonas vaginalis vaginitis, i.e., it is the most prevalent of the vaginitides. The pathogenesis of this syndrome is poorly defined and the characteristics of some novel members of the vaginosis-associated flora require further study. The objectives of the proposed studies are to better define the microbiology and pathogenesis of bacterial vaginosis (BV). The long term goals are better methods for diagnosis, treatment, and prevention of BV. These are four specific aims. 1) To examine the source and biological function of amines present during BV, the following studies will be performed; a) thin layer chromatography will be used to test clinical isolates of vaginosis-associated organisms for deaminase-dihydrolase activity after they have been grown on induction agar; b) a differential medium will be developed to allow recovery of amine producing organisms from the mixed vaginosis-associated flora; c) the effect of putrescine and cadaverine on growth of vaginosis-associated and endogenous vaginal flora will be determined in vitro. 2) In vitro studies will be performed to study interactions between members of the vaginosis-associated flora and between them and members of the endogenous vaginal flora. Direct and deferred agar methods will be used to test for antagonism, and broth methods to test for stimulation. 3) Prevalence and identity of curved, anaerobic, motile rods; a) the biochemical characteristics of these organisms will be determined, b) a selective medium will be designed for their recovery from the mixed vaginosis-associated flora, and c) this medium will be used to more accurately determine the prevalence of these organisms in bacterial vaginosis, vaginitis, and normal controls. 4) Identity and antimicrobial susceptibility of vaginosis-associated flora. A subset of BV patients fail to respond to repeated treatment trials with metronidazole, the drug of choice, or other antimicrobials; a) the vaginal flora of these patients will be compared with the flora in responsive BV patients; b) the minimum inhibitory concentration of antimicrobials will be determined to detect differences between isolates from these two groups of patients and to determine alternate therapeutic measures. Isolates will also be tested for the presence of Beta-lactamase.